Blood test, vitamin B12
Facility: Scott County Hospital
Billing Code: 82607 (CPT)
- CPT Billing Code: 82607
- Insurance Median: $86
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.70x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $15.08 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 570% of the Medicare baseline (a markup of 470%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $15 - $90 | 99% |
| Humana | $40 | 265% |
| Blue Cross Blue Shield | $57 | 378% |
| Wppa | $57 - $1,200 | 378% |
| Aetna | $86 | 570% |
Consumer Guidance & Cost Commentary
For CPT code 82607, a blood test for vitamin B12, Scott County Hospital's negotiated rates range from $15 to $1,200 across five payers, with a median negotiated amount of $86. This figure is notably higher than the Medicare benchmark of $15.08, reflecting the typical commercial markup where negotiated rates often exceed 200% of the federal baseline. While the facility is a Critical Access Hospital in Scott City, KS, and offers a voluntary non-profit structure, patients should be aware that commercial contracts can vary significantly; for instance, UnitedHealthcare plans show a wide spread between their low and high negotiated amounts. Because insurance billing includes administrative overhead and contract management costs, the actual amount you owe may differ from the allowed amount shown on your statement, especially if your plan has not yet met its deductible.
To minimize out-of-pocket costs, it is advisable to compare the facility's cash price against your specific insurance allowed amount, as paying cash directly can sometimes be cheaper than the negotiated rate if your plan's deductible is high. Many hospitals offer prompt-pay discounts for upfront payments, which can bypass the administrative fees associated with insurance claims processing. Before scheduling, contact the billing department to confirm whether "self-pay" or "prompt-pay" rates apply and request a waiver of insurance submission to ensure you are not automatically billed at the full negotiated rate. Additionally, always request a detailed, itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered, which can be corrected through a formal written audit dispute.